| Doctor Name: | TIFFANY ROMERO PERALTA |
| NPI Number: | 1093055667 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ACNS-BC |
| License Number: | CNS-00241 |
| Business Practice Address: | 101 N 6th St Belen, NM - 870023605 |
| Business Phone Number: | 5058644646 |
| Business Fax Number: | |
| Mailing Address: | 101 N 6th St, BELEN |
| State: | NM |
| Postal Code: | 870023605 |
| Phone Number: | 5058644646 |
| Fax Number: | |
| NPI Enumeration Date: | 02/19/2013 |
| NPI Last Update Date: | 02/19/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364SA2200X |
| License Number: | CNS-00241 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |